=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700465176
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTHEAST COLORADO HEALTH DEPARTMENT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/05/2021
-----------------------------------------------------
Last Update Date | 09/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 228 W RAILROAD AVE
-----------------------------------------------------
City | FT MORGAN
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80701-2324
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-522-3741
-----------------------------------------------------
Fax | 970-522-1412
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 700 COLUMBINE ST
-----------------------------------------------------
City | STERLING
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80751-3728
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 970-522-3741
-----------------------------------------------------
Fax | 970-522-1412
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PUBLIC HEALTH DIRECTOR
-----------------------------------------------------
Name | PATRICIA LAYNE MCCLAIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 970-967-4918
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223D0001X
-----------------------------------------------------
Taxonomy Name | Public Health Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------